Kevin Dean Krause
Individual provider Active NPI Driver · Saint Peters, MO
NPI 1447735865 · NPPES record last updated Oct 2, 2018
Key facts
- NPI
- 1447735865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- T003155013 (MO)
- Practice address
- 14 Horizon Dr
Saint Peters, MO 63376-3555 - Phone
- (636) 290-0534
- NPI assigned
- Oct 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T003155013 | MO | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | T003155013 | MO | Yes |
Addresses
Primary practice location
14 Horizon Dr
Saint Peters, MO 63376-3555
Mailing address
14 Horizon Dr
Saint Peters, MO 63376-3555
Phone (636) 290-0534
Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.